Lean or Toyota Production System (TPS) is responsible for revolutionizing the auto industry by creating highly reliable and safe cars and trucks. In this course healthcare providers, administrators, engineers, and healthcare professional students will be taught how to apply the principles and tools of Lean to health care. They will learn how to identify and remove of waste, design standardized work, apply 5S, map Value streams, create process maps, conduct rapid improvement events (RIEs), level workflow, use A3 forms and Paredo charts, apply error proofing, and create effective visual controls. The instructional videos minimize Lean technical language, and include patient cases to make the lessons more appealing to students in healthcare. Acknowledging that patients are very different from cars we have carefully adapted Lean to health care and call our system: Patient-centered Healthcare Delivery System (PHDS). The name and abbreviation emphasize two key principles taught in our course: 1. Just like PhDs the scientific method must be continually applied when creating plans to improve our systems of care. 2. All improvements must be made looking through the eyes of patients. Armed with this new knowledge students will be able to design and implement sustainable healthcare delivery system improvements.

From the lesson

Error Proofing and Visual Controls

Preventable medical errors are estimated to kill 100,000 to 440,000 people per year in the U.S. and similar levels of harm due to medical errors have also been observed in other countries. In order to effectively eliminate errors, we must first be able to recognize and report them and different types of error reporting are described. Secondly there must be a culture in place that deals fairly with errors by differentiating systems errors from individual human errors. This can be accomplished by applying a Just Culture. Additional tools for eliminating errors and improving processes are introduced including: the Pareto Chart, Failure Mode and Effects Analysis (FMEA), an expanded Plan, Do, Study, Adjust cycle, and the A3 form. There are 6 levels of error proofing and their effectiveness in preventing errors from reaching patients is assessed using clinical examples. Visual controls can be helpful for reducing errors and for following the progress of work process improvements. In the final video the major topics covered in this course are summarized, and a new name for TPS or Lean adapted to healthcare is proposed: Patient-centered Healthcare Delivery System (PHDS). This name emphasizes the importance of applying the scientific method, like PhDs, to continually improve healthcare delivery while always focusing on the needs of patients.